Nifedipine as a Uterine Relaxant for External Cephalic Version

• DOI: 10.1097/aog.0b013e31817f1f2e
• Publication Date: 2010-11-30T12:46:33Z
• Authors: Marjolein Kok; Joke M. Bais; Jan M. van Lith; Dimitri M. Papats...; Gunilla Kleiverda; Dahrs Hanny; Johannes P. Doornbos; Ben W. Mol; Joris A. van der ...
• Keywords: External cephalic version; Muscle relaxant

In Brief OBJECTIVE: To estimate the effectiveness of nifedipine as a uterine relaxant during external cephalic version to correct breech presentation. METHODS: this randomized, double-blind, placebo-controlled trial, women with singleton fetus in presentation and gestational age 36 weeks or more were eligible for enrollment. Participating received two doses either 10 mg placebo, 30 15 minutes before attempt. The primary outcome was cephalic-presenting immediately after procedure. Secondary measures at delivery, mode adverse events. A sample size 292 calculated provide 80% power detect 17% improvement success rate, assuming placebo group rate 40% alpha .05. RESULTS: Outcome data 310 320 randomly assigned participants revealed no significant difference rates between treatment (42%) control (37%) (relative risk 1.1, 95%; 95% confidence interval 0.85–1.5). cesarean delivery 51% 46% 0.88–1.4). CONCLUSION: Nifedipine did not significantly improve version. Future use should be limited large clinical trials. CLINICAL TRIAL REGISTRATION: Current Controlled Trials, http://isrctn.org, ISRCTN 28715121 LEVEL OF EVIDENCE: I does